Rationale and methodology for injection therapy to treat rotator cuff disease: a scoping review

Abstract

Rotator cuff disease is a prevalent musculoskeletal condition associated with significant pain and functional impairment. Various injection therapies, ranging from corticosteroids to advanced biologic approaches, offer potential solutions for managing rotator cuff disease. This scoping review consolidates evidence on the efficacy, safety, and mechanisms of these treatments. Corticosteroid injections, while effective for short-term pain relief, pose risks of tendon degeneration with prolonged use. Platelet-rich plasma demonstrates promise in promoting tendon healing and improving long-term outcomes, but variability in preparation methods limits its clinical consistency. Hyaluronic acid and prolotherapy show potential in improving pain and tendon function, often serving as adjuncts in combined therapeutic strategies. Emerging regenerative options, such as polydeoxyribonucleotide and bone marrow aspirate concentrate, leverage growth factors and stem cells to enhance tendon repair and reduce degeneration, with preliminary evidence supporting their clinical efficacy. By synthesizing current knowledge on injection therapy for rotator cuff disease, this review provides valuable insights for clinicians and researchers seeking to enhance the management of rotator cuff disease through injection therapy.

Keywords: Impingement syndrome; Injection; Review; Tear; Rotator cuff.

Fig. 1.

Mechanism of polydeoxyribonucleotide (PDRN). VEGF: vascular endothelial growth factor.